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The Collaborative Home Infant Monitoring Evaluation

Jean M. Silvestri, MD; George Lister, MD; Michael J. Corwin, MD; Sheilah M. Smok-Pearsall, RN; Terry M. Baird, MD; David H. Crowell, PhD; Jean Cantey-Kiser, PhD; Carl E. Hunt, MD; Larry Tinsley, MD; Paula H. Palmer, PhD; Rebecca S. Mendenhall, MS; Toke T. Hoppenbrouwers, PhD; Michael R. Neuman, PhD, MD; Debra E. Weese-Mayer, MD; Marian Willinger, PhD; for the Collaborative Home Infant Monitoring Evaluation (CHIME) Study Group

Arch Pediatr Adolesc Med. 2005;159:18-24.

Background  As part of the Collaborative Home Infant Monitoring Evaluation, a home monitor was developed to record breathing, heart rate, other physiologic variables, and the time the monitor was used.

Objective  To determine the frequency of monitor use, factors that influence use, and validity of a model developed to predict use.

Design  We developed a model to predict monitor use using multiple linear regression analysis; we then tested the validity of this model to predict adherence for the first week of monitoring and for the subsequent 4-week period (weeks 2-5).

Setting  Clinical research centers in Chicago, Ill; Cleveland, Ohio; Honolulu, Hawaii; Los Angeles, Calif; and Toledo, Ohio.

Patients  Preterm infants, infants younger than 1 month with a history of autopsy-confirmed sudden infant death syndrome in a sibling, and infants with an idiopathic apparent life-threatening event were divided into 2 cohorts based on enrollment date.

Main Outcome Measure  Mean hours of monitor use per week.

Results  In cohort 1, the variables available before monitoring were only weakly associated with total hours of monitor use in weeks 2 to 5 (total model r² = 0.08). However, when hours of monitor use in week 1 were included as a variable to predict monitor use in weeks 2 to 5, the r² increased to 0.64 for hours of monitor use per week.

Conclusions  Our data show that monitor use in the first week was the most important variable for predicting subsequent monitor use. The study suggests that a major focus of home monitoring should be adherence in the first week, although it remains to be tested whether this adherence can be altered.

Author Affiliations: Department of Pediatrics, Rush Medical College of Rush University, Rush Children’s Hospital, Chicago, Ill (Drs Silvestri and Weese-Mayer and Ms Smok-Pearsall); Department of Pediatrics, The University of Texas Southwestern Medical School, Dallas (Dr Lister); Departments of Pediatrics and Epidemiology and Biostatistics, Boston University Schools of Medicine and Public Health, Boston, Mass (Drs Corwin and Cantey-Kiser); Departments of Pediatrics (Dr Baird) and Obstetrics and Gynecology (Ms Mendenhall and Dr Neuman), Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, Ohio; Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii at Manoa, Kapiolani Medical Center for Women and Children, Honolulu (Drs Crowell and Tinsley); Department of Pediatrics, Medical College of Ohio, Toledo (Dr Hunt); Department of Pediatrics and Neonatology, University of Southern California School of Medicine, Los Angeles; Los Angeles County and University of Southern California Medical Center, Women’s and Children’s Hospital, Los Angeles (Drs Palmer and Hoppenbrouwers); and Pregnancy and Perinatology Branch, Center for Research for Mothers and Children, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Md (Dr Willinger).

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